You might be wondering: “Are there VA disability claims that cannot be proven?”
The short answer is no.
Because if you have no evidence (no proof), your VA claim will be denied.
In addition, you must clear various hurdles to even be eligible for VA benefits.
First, you must meet the 2 elements for VA benefits eligibility, which include (#1) An “Honorable” Discharge and (#2) Time served on active duty military orders.
Second, you must prove 4 critical elements to the VA, on a legal standard called “at least as likely as not.” (An even lower burden of proof than “preponderance of the evidence.”)
If there’s a tie (50/50), the veteran wins.
These 4 foundational pillars make up what we call “The VA Claims Insider Golden Circle.”
Here’s the decision tree for all VA disability compensation claims, assuming you’re eligible for benefits under the law:
- #1. Diagnosis of a current disability in a medical record. If yes, go to #2.
- #2. Evidence of an in-service event, injury, disease, or aggravation. If yes, go to #3.
- #3. “Nexus” meaning link or connection between #1 and #2 above via competent medical evidence. If yes, go to #4.
- #4. Severity of symptoms in terms of frequency, severity, and duration. This is the final step in “The Caluza Triangle” and it’s what determines your final VA rating percentage for the disability.
Before we go on, let’s cover the 11 categories that might make a veteran ineligible for VA disability benefits.
Lastly, we’ll explore the 6 critical factors to getting your VA claim approved.
- Who is NOT Eligible for VA Disability Benefits?
- Are There VA Disability Claims That Cannot Be Proven?
- Factor #1: Honorable Discharge.
- Factor #2: Time Served on Active Duty Military Orders.
- Factor #3: Diagnosis of a Current Disability in a Medical Record.
- Factor #4: Evidence of an In-Service Event, Injury, Disease, or Aggravation.
- Factor #5: “Nexus,” Meaning Link or Connection Between #3 and #4 via Competent Medical Evidence.
- Factor #6: Severity of Symptoms in Terms of Frequency, Severity, and Duration.
- About the Author
Who is NOT Eligible for VA Disability Benefits?
Here’s a list of veterans who are not eligible for VA disability benefits (11 categories):
- You didn’t serve any time on active duty military orders.
- You have a “Dishonorable” Discharge that hasn’t been upgraded.
- You have a “Bad Conduct” Discharge that hasn’t been upgraded.
- You have an “Other Than Honorable” Discharge that hasn’t been upgraded.
- Your disability is due to your own willful misconduct.
- You were a conscientious objector who refused to perform military duty, wear the uniform, or comply with lawful orders of competent military authorities.
- You received a sentence of a General Court-Martial (GCM).
- You were discharged under “resignation by an officer for the good of the service.”
- You were discharged for “desertion.”
- You were found to be an alien during a period of hostilities.
- You were Absent Without Official Leave (AWOL) for continuous period of at least 180 days.
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Are There VA Disability Claims That Cannot Be Proven?
No, there aren’t any VA disability claims that cannot be proven.
In fact, all VA claims must be proven on an “at least as likely as not” basis.
If you have no evidence (no proof), your VA claim will get denied.
Also, you must first ensure you’re even eligible for VA disability benefits under the law.
Generally, veterans need (1) An “Honorable” Discharge, (2) Time served on active duty military orders, (3) Diagnosis of a current disability in a medical record, (4) Evidence of an in-service event, injury, disease, or aggravation. (5)“Nexus” meaning link or connection between #3 and #4 via competent medical evidence, and (6) Severity of symptoms in terms of frequency, severity, and duration.
Let’s explore these 6 factors in-detail.
Factor #1: Honorable Discharge.
First and foremost, you need an “Honorable” Discharge from the military.
If you received a Discharge of “Other Than Honorable,” “Bad Conduct,” or “Dishonorable,” you must upgrade your discharge characterization to get VA benefits.
If you’re unsure of your status, you can check your discharge characterization on your DD 214.
To apply for a Discharge upgrade with your branch of service, click HERE.
Veterans can also apply for VA benefits first and ask the VA to complete a Character of Discharge Determination (COD), however, you typically must show “mental defect” at the time of discharge.
Factor #2: Time Served on Active Duty Military Orders.
Second, you must be considered a “veteran” who served on active duty orders, active duty for training, or inactive duty training.
Eligibility for VA benefits largely depends on a “Veteran Status” determination made by the VA, to include length of service, service commitment, and the number of days spent on active duty orders.
Click HERE to review M21-1 – Chapter 6 – Establishing Veteran Status, to review the complete decision matrix used by VA Rating Officials to determine VA benefits eligibility.
Are you National Guard or Reserve?
Here’s a helpful guide on VA benefits for Guard and Reserve members.
Factor #3: Diagnosis of a Current Disability in a Medical Record.
Third, you must have a medical diagnosis of a current disability in a medical record.
The diagnosis can be in service treatment records, VA medical records, or private medical records to include a DBQ or Nexus Letter.
For example, if you file a claim for PTSD and don’t yet have a diagnosis, your VA claim will be denied.
If you don’t have a diagnosis of the disability you’re filing for, go see your primary care provider or other specialist before applying for VA benefits.
You’ll thank us later!
Factor #4: Evidence of an In-Service Event, Injury, Disease, or Aggravation.
Fourth, you must provide evidence of an in-service event, injury, disease, or aggravation that caused or made your disability worse.
Here’s a quick litmus test to think about: Do you have medical evidence?
If not, you better get some in VA medical records or private treatment records before filing a VA claim.
Your DD 214, a credible Buddy Letter, and/or a Statement in Support of a Claim can all help prove your case, but you still need medical evidence of a current disability.
Again, you need to be thinking of the link or connection between factors #4 and #5.
For example, constant rocket and mortar attacks in Afghanistan might have caused you to fear for your life, and subsequently led to your PTSD.
Or maybe you got injured during a training accident while on active duty and now you have shoulder and neck pain as a result.
Perhaps you entered the military with flat feet, but your military service worsened the condition beyond its natural progression.
Factor #5: “Nexus,” Meaning Link or Connection Between #3 and #4 via Competent Medical Evidence.
Fifth, there must be a “Nexus” for service connection between factors #3 and #4 above.
If you can’t prove a link or connection between your disability and your military service, you’ll likely get denied VA disability benefits.
There are 5 types of service connection under the law.
#1. Direct Service Connection
This is the most common method of service connection for VA disability compensation benefits.
You’re telling the VA that your current disability condition is the direct result of your active duty military service.
Maybe it was a training incident, car accident, combat deployment, stress from the job, or other in-service incident, injury, event, or disease that directly caused or made your current disability condition worse.
An example is combat PTSD due to an IED attack in Iraq.
The PTSD is due to your combat deployment, which is directly related to your military service.
#2. Secondary Service Connection
In accordance with 38 CFR § 3.310 current disability condition that is proximately due to or the result of a service-connected disease or injury shall also be service connected.
Let’s say, for example, you developed ringing in your ears, called “Tinnitus” while serving.
Today, even though you are no longer serving, that service-connected tinnitus might be causing migraine headaches, anxiety, and/or depression.
Service connection on a secondary basis requires a “showing of causation.”
Instead of proving that your disability is directly service-connected, you’ll need to prove that it’s caused or made worse by a different disability (which is service-connected).
In this example, you could file a VA disability claim for migraine headaches secondary to your service-connected tinnitus.
Pro Tip: A Nexus Letter is highly recommended to help you prove secondary service connection under the law. >> Click HERE NOW << to sign up for our premier education-based Coaching/Consulting program VA Claims Insider Elite, start free today, connect with a Veteran Coach in minutes, and get high-quality Nexus Letters at reduced rates (if wanted and warranted by the evidence of record).
#3. Presumptive Service Connection
If your disability condition meets certain criteria (set forth by Congress), then your disability condition will be presumed to have been caused by service.
Examples include certain chronic debilitating diseases, diseases specific to radiation exposure, diseases associated with herbicide agents (to include Blue Water Veterans), Persian Gulf War Veterans and Burn Pit Exposures, and Camp Lejeune Veterans.
38 CFR § 3.309 discusses diseases subject to presumptive service-connection in more detail.
Pro Tip: While you are not required to provide a “Nexus” to establish presumptive service connection, it’s highly recommended that you at least write a personal statement as to WHY you think your disability meets the legal requirements for presumptive service connection. You might want to obtain a medical nexus letter as well.
#4. Service Connection by Aggravation
Sometimes a pre-existing condition is worsened by military service.
For example, a veteran may have had flat feet prior to entering service but wearing military boots and prolonged standing worsened his or her flat feet leading to a painful disability called plantar fasciitis, which is eligible for compensation under the law.
Additionally, if a veteran has a service-connected knee condition that aggravates a non-service-connected back condition, they could get service connection for their back based on aggravation—provided they can prove that their condition was worsened beyond its natural progression by military service.
#5. Service Connection by 38 U.S.C 1151
This refers to disabilities or death that result from “hospital care, medical or surgical treatment, or examination” by a VA medical professional or facility, or due to participation in a program of vocational rehabilitation.
In our experience, this is uncommon.
Factor #6: Severity of Symptoms in Terms of Frequency, Severity, and Duration.
The sixth and final factor we call “Severity of Symptoms” in terms of frequency, severity, and duration.
- Frequency means how often your disability occurs (never, sometimes, always).
- Severity is how badly the disability affects you (not severe, sometimes severe, always severe).
- Duration refers to how long the disability symptoms last (not long, sometimes long, always long).
Remember the VA disability compensation system provides veterans with tax-free monetary relief for the average impairment of earnings capacity.
This makes good sense, because if your disability doesn’t affect you, the VA won’t compensate you for that condition.
On the other hands, if your disability is severe and it affects you often, the VA will compensate you for that condition—typically at the higher disability percentage.
The VA Rater will select the disability percentage evaluation based on a “preponderance of the symptoms.”
For example, if you have 3 symptoms of the 10% rating level, 4 symptoms of the 30% level, and 2 symptoms of the 50% level, the “preponderance” of your symptoms is at the 30% rating criteria.
Generally, the more severe your disability, the higher the VA rating you’ll receive.
Keep this in-mind when talking to your doctor, sourcing a Buddy Letter, writing a Statement in Support of a Claim, or attending a C&P Exam.
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About the Author
Brian Reese is one of the top VA disability benefits experts in the world and bestselling author of You Deserve It: The Definitive Guide to Getting the Veteran Benefits You’ve Earned (Second Edition).
Brian’s frustration with the VA claim process led him to create VA Claims Insider, which provides disabled veterans with tips, strategies, and lessons learned to win their VA disability compensation claim, faster, even if they’ve already filed, been denied, gave up, or don’t know where to start.
As the founder of VA Claims Insider and CEO of Military Disability Made Easy, he has helped serve more than 10 million military members and veterans since 2013 through free online educational resources.
He is a former active duty Air Force officer with extensive experience leading hundreds of individuals and multi-functional teams in challenging international environments, including a combat tour to Afghanistan in 2011 supporting Operation ENDURING FREEDOM.
Brian is a Distinguished Graduate of Management from the United States Air Force Academy, Colorado Springs, CO, and he holds an MBA from Oklahoma State University’s Spears School of Business, Stillwater, OK, where he was a National Honor Scholar (Top 1% of Graduate School class).